Provider Demographics
NPI:1518039478
Name:PENDLETON, JAMES E (ND)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:PENDLETON
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 152ND AVE NE STE W
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5521
Mailing Address - Country:US
Mailing Address - Phone:425-207-3476
Mailing Address - Fax:206-681-9987
Practice Address - Street 1:2007 152ND AVE NE STE W
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5521
Practice Address - Country:US
Practice Address - Phone:425-207-3476
Practice Address - Fax:425-207-3092
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIND-206175F00000X
AZ06-956175F00000X
CAND-259175F00000X
WANT00000965175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2128520Medicaid